Fallopian tube prolapse presenting as a peritoneovaginal fistula

Peritoneovaginal fistula is an extremely rare cause of persistent vaginal leakage following a hysterectomy. Likewise, fallopian tube prolapse is an uncommon but known complication of hysterectomy. Fallopian tube prolapse resulting in peritoneal leakage has yet to be reported in the literature.

A 27-year-old female presented with a two year history of continuous leakage per vagina. The leakage started shortly after an abdominal hysterectomy. Examination noted clear fluid emanating from a vaginal lesion located at the level of the vaginal cuff. An extensive workup ruled out vesicovaginal and ureterovaginal fistula. Surgical exploration noted that the lesion was a prolapsed fallopian tube, which was resected vaginally.

This is the first reported case of peritoneovaginal fistula associated with a prolapsed fallopian tube.

Vaginal resection of the fallopian tube remnant and reclosure of the vaginal cuff results in cure of the leakage.